Slow Processing Speed Predicts Falls in Older Adults With a Falls History: 1-Year Prospective Cohort Study

J Am Geriatr Soc. 2017 May;65(5):916-923. doi: 10.1111/jgs.14830. Epub 2017 Apr 8.

Abstract

Background/objectives: A previous fall is a strong predictor of future falls. Recent epidemiologic data suggest that deficits in processing speed predict future injurious falls. Our primary objective was to determine a parsimonious predictive model of future falls among older adults who experienced ≥1 fall in the past 12 months based on the following categories: counts of (1) total, (2) indoor, (3) outdoor or (4) non-injurious falls; (5) one mild or severe injury fall (yes vs no); (6) an injurious instead of a non-injurious fall; and (7) an outdoor instead of an indoor fall.

Design: 12-month prospective cohort study.

Setting: Vancouver Falls Prevention Clinic, Canada (www.fallsclinic.ca).

Participants: Two-hundred and eighty-eight community-dwelling older adults aged ≥70 years with a history of ≥1 fall resulting in medical attention in the previous 12 months.

Measurements: We employed principal component analysis to reduce the baseline predictor variables to a smaller set of five factors (i.e., processing speed, working memory, emotional functioning, physical functioning and body composition/fall risk profile). Second, we used the extracted five factors as predictors in regression models predicting the incidence of falls over a 12-month prospective observation period. We conducted regression analyses for the seven falls-related categories (defined above).

Results: Among older adults with a falls history, processing speed was the most consistent predictor of future falls; poorer processing speed predicted a greater number of total, indoor, outdoor, and non-injurious falls, and a greater likelihood of experiencing at least one mild or severe injurious fall (all P values < .01).

Conclusion: Poorer performance on the processing speed factor, a trainable factor, was independently associated with the most costly type of falls-injurious falls.

Keywords: falls; indoor fall; injurious fall; older adults; outdoor fall.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • British Columbia
  • Female
  • Geriatric Assessment*
  • Humans
  • Incidence
  • Male
  • Neuropsychological Tests / statistics & numerical data*
  • Prospective Studies
  • Risk Assessment